Several of my patients in the past week have told me how frustrating it is that close friends and family can’t seem to be supportive. Specifically, two of my current infertility patients were appalled that pregnant friends had the audacity to complain about their pregnancies. Given that research shows that the majority of women with infertility tell no one about their infertility, including their own mothers, it is actually somewhat hard to blame someone for complaining to someone else who is experiencing a crisis the opposite of yours, but hasn’t told you what that crisis it. And yes, I know the previous sentence was hard to understand.

The fact is, we all tend to focus on what is wrong in our lives. So an infertiltiy patient is going to focus on her infertility, and a pregnant woman is going to focus on the physical and emotional consequences of pregnancy. Ironically, each may be envious of the other. I guess the takeaway message here is to be cautious about who you complain to. If you have a friend who has been married for a while and doesn’t have kids, she might well be experiencing infertility so complaning about your pregnancy or your kids might not be well received. If you are financially stable and you have a friend who was recently laid off, don’t complain that you couldn’t get a reservation at the hottest new restaurant in town. I am not saying that complaining per se is bad. I am merely advising that before you list your grievances to anyone else, do a mental check on that person’s life to make sure you aren’t adding salt to their wounds.

I attended a lecture last year on the topic of epigenetics, which includes the study of the impact of the uterine environment on the developing baby. A huge area of controversy is the impact of stress during pregnancy. Is stress bad for the baby? Good for the baby? Is a little bit of stress better than no stress? As one of the speakers pointed out, if a woman is highly anxious during her pregnancy, and delivers a baby who grows up to be an anxious kid, does this mean that anxiety during pregnancy caused the child to be anxious? Or does this mean that an anxious woman may have a genetic predisposition to anxiety that she simply passed on to her child? There is no easy way to answer this question. One would have to study children both through surrogacy (where a non biologically related woman carries the child) and born via egg donation (where the child is created from a donated egg and carried by the intended mom) versus children created from the mom’s egg and carried by the mom. You would need to study them throughout the pregnancy, and then follow the kids for years. Given the time and expense of a study like that, it isn’t going to happen so I don’t see us knowing the answer anytime soon.

But, being anxious during pregnancy isn’t all that fun. So as opposed to worrying about the impact of stress on the developing baby, wouldn’t it make more sense simply to teach pregnant women how to reduce stress? That is my goal. I counsel pregnant women daily, and the main focus is how to relieve their heightened stress levels.

For this blog, I am going to try to address the issues which face my patients. Here’s an example. Two of my patients today emailed me about possibly worrisome test results. The odds are in their favor that their babies are fine, but the test results won’t be back for a week. Both women are anxious and upset. I gave them each the same advice. Don’t think about how you are going to survive until next week. Focus on today. What can you do today to support yourself? What can you do to distract yourself? What works for you when you are anxious? Tomorrow, do the same thing. What can you do to keep yourself distracted and as calm as possible tomorrow?

Even though approximately half of the pregnancies in this country are unplanned, the vast majority of the pregnant women I see for counseling very much want to be pregnant. But I think that most pregnant women do the rest of us a disservice, since people aren’t necessarily all that honest about how they feel. Most of my patients feel incredibly embarrassed about complaining about their symptoms, and perceive that they won’t get much sympathy from others, since after all, they conceived purposefully.

But I am here to trumpet the fact that no matter how much you may have wanted to conceive, that doesn’t guarantee that you will feel fabulous for nine months. People do talk about morning sickness, and among close friends, the need to pee all the time. But most women don’t feel comfortable talking openly about how they are really feeling, except maybe to their partner. Even their mother may not provide all that much sympathy. I remember telling my mom how tired I was of being nauseous all the time, about 12 weeks into my first pregnancy. Her response? That she was nauseous for the whole nine months with me, so I didn’t have all that much to complain about. Yet.

There are many women who feel great during their pregnancies, and some who say it is the best they ever feel. I am envious. But for most women, the fatigue and nausea and bloating and gas and constant trips to the bathroom and hemorrhoids and vomiting are the norm. Temporary for sure, but still harder than most women were led to expect. So if you are feeling yuckier than you expected, please don’t feel guilty or odd or worry that this means you aren’t going to be a happy mother. There is some research which says that the harder you have to work for something, the more you enjoy it when you achieve it (which is why I think that lobster and ribs are my favorite foods). So if that is the case, if you are feeling less than wonderful, perhaps it means you will enjoy or appreciate motherhood even more.

i have been counseling women with infertilty for more than 25 years, so the last thing you would expect is for me to be writing about the challenges of being pregnant. But to be honest, no matter how much a woman may want to conceive, being pregnant can be a lot more challenging than one would expect. This has led me to start work on a new book, my first in about five years, called The Stress Bump, along with my co-author Alice Lesch Kelly.

Since we conceived the idea (sorry, I couldn’t resist) last year, I have been paying even more attention to what my pregnant patients tell me. Their complaints, observations, and stories have led me to believe that we are really onto something with the idea that being pregnant can be truly stressful, no matter how much you might want to be a mom. There is this immense social expectation that to be pregnant is to have achieved nirvana. You are supposed to glow, to be radiant, to anticipate impending motherhood with serenity and bliss.But my own experience and that of most of my patients tells a far dfferent story. Pregnancy can be hard.

Thus, as of today this blog is going to focus on the ups and downs of pregnancy. I will tell stories from my patients, give advice on how to feel better physically and psychologically during pregnancy, but I am going to be realistic about what to expect (sorry, couldn’t resist that either).

One of my patients asked me a couple of years ago if it was a good idea or a bad idea to compare herself to others. It took me a minute to think about it, but I then said that although it is of benefit to compare oneself with those who are worse off than you, we don’t tend to do that. We always compare up. So for example, the woman who is 20 pounds overweight and miserable about it doesn’t look at a woman who is 30 pounds overweight and suddenly feel buff. No, she looks at the size 2 woman and basically mentally beats herself up. But the research shows that when we are with people less fortunate than us, we feel better. I am not an especially happy flyer. Takeoffs make me really anxious (yet I fly all the time to give talks). However, if I am sitting next to someone who is even more afraid than I am, I feel fine.

So the next time you are worried or anxious or feeling envious, stop and ask yourself where you fall on the spectrum of whatever you are upset about. And try to catch yourself each time you find yourself comparing up.